This application is an investigator-initiated Exploratory/Developmental Research Grant (R21). It proposes a bi-national and multidisciplinary team to conduct an exploratory study to establish the feasibility and modifications needed for employing research strategies and instruments utilized in similar research in Nicaragua and among Hispanic immigrant communities of New York to explore drug use and STI/HIV risk among Colombian refugees in Ecuador. The (4)study aims include: 1) Identification of the sociodemographic characteristics, migratory/refugee trajectories, and health risk characteristics of recent Colombian refugees in Ecuador; 2)exploration of the contextual and behavioral factors influencing STI/HIV risk; 3) identification of prevention and care resources utilized by the refugee community, as well as community/social action which has/is addressing structural violence (e.g. stigma, discrimination) and community- perceived health risks; and 4) development of institutional capacity in the NGO sector for immigrant health research in Ecuador, focusing on drug use and STI/HIV risk. These aims reflect the urgent need for descriptive data on the large and growing Colombian refugee population in Ecuador, specifically the contextual and behavioral risk factors that influence vulnerability for contracting HIV/AIDS and other sexually transmitted infections. The development of effective prevention programs and public health interventions require a more complete understanding of the migration process and vulnerabilities of immigrants/refugees as they cross international borders, especially the understudied South and Central American borders. The aims also reflect a response to the need for capacity building in immigrant health research internationally, and in Ecuador, specifically, by local non-governmental organizations who are the most able to reach these populations with effective interventions. The findings will be used to inform future studies that are essential in the development of more effective prevention and control programs for immigrant and refugee populations. PUBLIC HEALTH RELEVANCE: This study reflects the urgent need for descriptive data on large and growing refugee populations, specifically the contextual and behavioral risk factors that influence vulnerability for contracting HIV/AIDS and other sexually transmitted infections. The development of effective prevention programs and public health interventions require a more complete understanding of the migration process and vulnerabilities of immigrants/refugees as they cross international borders. The study aims also reflect a response to the need for capacity building in immigrant health research internationally, specifically by local non-governmental organizations who are the most able to reach these populations with effective interventions.